Seventy-four-year-old Bill Sandquist has farmed 300 acres southwest of Adel, Iowa, for 54 years. But the last six have been entirely different.

“I used to raise a lot of hogs, used to feed cattle,” Sandquist said. “Then in ’05, when cancer took my arm, I had to give up the hogs. Basically, we’re grain farmers now and partially retired, too.”

Sandquist is among the one-fifth of U.S. farmers who work the land with some type of physical disability, according to estimates by the National AgrAbility Project. That’s compared to the 6 percent of the overall workforce who are disabled.

And for Sandquist, the transition was sudden.

After he harvested his crops six years ago, Sandquist noticed the muscle in his lower right arm was growing larger. He was diagnosed with sarcoma, a form of cancer that strikes bones and the body’s connective tissues. Doctors recommended quick amputation. Bill’s wife, Colleen, said the news hit their three sons hard.

“They wanted us to go to all different places and get a second opinion and we didn’t think we had that much time,” she said. “They had told us chemo won’t work, radiation won’t work, and it’s either a life or a limb. Of course, we had to tell them on Christmas Eve, which didn’t help matters either.”

Surgeons removed Bill Sandquist’s right arm to the elbow and in its place, he wears a prosthesis.

“It’s not a bionic arm or hand by any means — it’s all physical with flexing my shoulder,” Sandquist said. “It’s pretty simple and I got on to it pretty quick.”

By shrugging his shoulder, Sandquist can open and close the metal claw that now serves as his right hand. The fact that he’s naturally left-handed has made it slightly easier to adjust to farming with one arm, but he has been forced to adapt pieces of equipment and now operates more things with his feet.

Sandquist’s giant combine has undergone a transformation – many of the controls have moved to the floorboard.

“First couple of years I combined, I didn’t have the foot controls and I did everything with my prosthesis and my left hand,” Sandquist said. “This just made it a lot easier.”

For advice on what modifications to make to his farm machinery, Sandquist turned to the Rural Solutions program offered by Easter Seals of Iowa. Over the last 25 years, Rural Solutions has helped more than 1,700 disabled Iowa farmers remain close to the land.

“Sometimes, due to the severity of a disability, a farmer may not desire, or it may not be safe, to return to the farming operation, so in some instances we may be just helping them to stay in their home,” said Tracy Keninger, the program’s director. “Perhaps a person with a high-level spinal cord injury — that may be their goal.”

Sandquist’s goal was to get back in the field.

“I just like to get up every morning and be part of the farm, part of agriculture, part of my family,” Sandquist said.

Farming is a physically demanding occupation and it places strain on Sandquist’s prosthesis. Even though it was constructed with a durable leather harness and reinforced cables, he has broken three prosthetic limbs since the amputation. Plus, the job is filled with an endless string of routine repairs that require agility.

“You know one thing I can’t do is pound a damn nail,” Sandquist said.

He said his greatest fear is losing grip with the prosthesis while climbing out of the combine and tumbling off.

Keninger said it’s common for disabled farmers to over-compensate for their disability and injure themselves.

“Despite the fact his prosthetic device operates very effectively for him…there’s still extra stress and strain on that left hand, the able-body side,” Keninger said. “We often see overuse in one portion of the body to compensate for where there may be a limitation.”

Keninger grew up on a farm near Ackley in north central Iowa. She decided to dedicate her career to farmers with disabilities after watching her father recover from a serious encounter with some rather large livestock.

Only about 20 percent of farmer disabilities are caused by farm accidents, according to estimates by the National AgrAbility Project. Most cases involve people surviving health conditions such as strokes, cerebral palsy and muscular dystrophy.

Sandquist said he has adapted pretty well and things are looking up on the farm. Thanks to the long, hot summer, they harvested a bumper crop this fall. And during Sandquist’s last semiannual checkup, there was no sign of the cancer that took his arm.

This report is third in a series from Iowa Public Radio titled "Being Physically Disabled In Iowa."